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 From the President

Prematurity

By Stephanie Birch, RNC, MPH, MS, FNP

The March of Dimes just released their annual Premature Birth Report Card for 2011. It was wonderful to see that overall the U.S. rate has declined nearly 5 percent from the 2006 peak of 12.8 percent. While this gives us cause for celebration, as maternal child health programs, we need to stay vigilant in continuing to work on reducing these rates.

By analyzing maternal and child health (MCH) data, states can learn more about what affects their prematurity rate. Many states share common associations of substance abuse, poverty, poor nutrition, high rates of late prenatal care and stress. But many states also have differing factors that influence their rates of prematurity. For instance, in Alaska our epidemiologists report that the use of alcohol and tobacco during pregnancy takes a huge toll on the health of women and babies. Women who drink alcohol during pregnancy risk giving birth to babies with Fetal Alcohol Syndrome (FAS) or Fetal Alcohol Spectrum Disorders (FASD), which cause irreversible birth defects and developmental disabilities. While smoking during pregnancy is the single most preventable known cause of infant low birth weight and prematurity.

Many states who have limited numbers of perinatal and neonatal specialists, like Alaska, have developed creative systems of care, based on the AAP/ACOG Guidelines for Perinatal Care, to enhance their screening and referral systems, improve their transport systems and maintain high levels of neonatal intensive care. While the neonatal outcomes have significantly improved over the past 20 years, the numbers of babies born too early and too small is still a challenge. Utilizing state data and working with health care partners to understand what the data is saying is an important first step to developing systems that support change and improve outcomes.

In this issue, you will learn about what AMCHP is doing to support states in their work to reduce the rates of prematurity, the work that new ASTHO President Dr. David Lakey is challenging states to focus on and the March of Dimes campaign to reduce the rates of prematurity.